| NPI | 1295543106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TX 869629) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: TX 700417) |
| 163WE0003X Registered Nurse, Emergency (Licence: TX 869629) | |
| Enumeration Date | 2024-12-23 |
| Last Update Date | 2024-12-23 |