| NPI | 1336023142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CO RN.1701992) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: CO Q191564) |
| Enumeration Date | 2025-08-04 |
| Last Update Date | 2025-08-04 |