| NPI | 1538491295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: MI 4704259547) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: MI 3203042050) |
| Enumeration Date | 2010-02-05 |
| Last Update Date | 2010-02-05 |