| NPI | 1144936691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MA RN2377548) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MA E0914836) |
| Enumeration Date | 2023-01-27 |
| Last Update Date | 2023-02-16 |