| NPI | 1366466211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: ME P00360) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: ME R028292) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-07-08 |