| NPI | 1356733661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: IL 041396285) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: IL 060032841) |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2015-02-23 |