| NPI | 1659149052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: CA 95305514) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: M5003709) |
| Enumeration Date | 2023-12-14 |
| Last Update Date | 2023-12-14 |