| NPI | 1467666297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: PR 5926) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: PR 605P) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-12-01 |