| NPI | 1134948193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: OR 201505032) |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate (Licence: OR 139405) |
| Enumeration Date | 2024-10-07 |
| Last Update Date | 2024-10-07 |