| NPI | 1376073270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: LA RN126248) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: LA TAP003251) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2017-06-14 |