| NPI | 1487446225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: VT 026.0040251) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: VT 8946) |
| Enumeration Date | 2025-05-19 |
| Last Update Date | 2025-05-19 |