| NPI | 1336399609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CO 187448) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: CO 021859) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2008-09-23 |