| NPI | 1548976954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: VA 0001314227) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: VA E202204899) |
| 163W00000X Registered Nurse (Licence: CA 752463) | |
| Enumeration Date | 2023-01-30 |
| Last Update Date | 2025-01-02 |