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 | 2024-06-04 |