| NPI | 1265965008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: FL RN9314202) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: FL PMD206372) |
| 163WE0003X Registered Nurse, Emergency (Licence: CT 96194) | |
| 163WE0003X Registered Nurse, Emergency (Licence: NY 638056-1) | |
| Enumeration Date | 2017-04-08 |
| Last Update Date | 2022-04-13 |