| NPI | 1487339560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WM0705X Registered Nurse, Medical-Surgical (Licence: AL 1-193352) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL 0800954) |
| Enumeration Date | 2023-06-16 |
| Last Update Date | 2023-06-16 |