| NPI | 1700250214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: PR 76929-G) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: PR 1013-P) |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2015-11-20 |