| NPI | 1457172108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TN 281873) |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate (Licence: TN 212388) |
| 183700000X Pharmacy Technician (Licence: TN 70973) | |
| Enumeration Date | 2024-10-24 |
| Last Update Date | 2024-10-24 |