| NPI | 1427403351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL RN9398955) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: FL PMD524468) |
| 146N00000X Emergency Medical Technician, Basic (Licence: FL EMT535359) | |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2016-04-28 |