| NPI | 1396369989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL RN9404734) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 146L00000X Emergency Medical Technician, Paramedic (Licence: FL pmd518742) | |
| 146N00000X Emergency Medical Technician, Basic | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: FL RN9404734) | |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: FL RN9404734) | |
| 163WE0003X Registered Nurse, Emergency (Licence: FL RN9404734) | |
| 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: FL RN9404734) | |
| Enumeration Date | 2020-05-30 |
| Last Update Date | 2020-05-30 |