| NPI | 1659955573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: CA 807488) |
| Enumeration Date | 2021-05-06 |
| Last Update Date | 2021-05-06 |