| NPI | 1235517079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WF0300X Registered Nurse, Flight (Licence: ID N-47481) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: ID 37139) |
| 146L00000X Emergency Medical Technician, Paramedic (Licence: MT MED-PARA-LIC-33359) | |
| 146L00000X Emergency Medical Technician, Paramedic (Licence: OR 130546) | |
| 163WF0300X Registered Nurse, Flight (Licence: WA RN60455585) | |
| 163WF0300X Registered Nurse, Flight (Licence: OR 201140887RN) | |
| 163WF0300X Registered Nurse, Flight (Licence: MT NUR-RN-LIC-72952) | |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2015-05-13 |