| NPI | 1174919062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: ME RN54296) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: ME 18959) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2015-04-08 |