| NPI | 1679990139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TX 954339) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: TX 707462) |
| 163WE0003X Registered Nurse Emergency (Licence: TX 954339) | |
| 163WP0200X Registered Nurse Pediatrics (Licence: TX 954339) | |
| 207PE0004X Emergency Medicine Emergency Medical Services (Licence: TX 707462) | |
| Enumeration Date | 2014-03-23 |
| Last Update Date | 2022-12-30 |