| NPI | 1417122656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WN0800X Registered Nurse, Neuroscience (Licence: CA 95171768) |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate (Licence: NM 07001184) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2019-03-01 |