| NPI | 1528893658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NV 881740) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: NV 105153) |
| Enumeration Date | 2024-09-06 |
| Last Update Date | 2024-09-06 |