| NPI | 1700015260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL RN 9243642) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: FL EMT 301744) |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2009-07-06 |