| NPI | 1316619117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: PR 33721) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic |
| 164W00000X Licensed Practical Nurse (Licence: PR 33721) | |
| 246RP1900X Technician, Pathology, Phlebotomy | |
| Enumeration Date | 2021-09-30 |
| Last Update Date | 2022-10-10 |