| NPI | 1760988307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL ARNP9223586) |
| Additional Taxonomies | 163WE0003X Registered Nurse Emergency (Licence: FL RN9223586) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 146L00000X Emergency Medical Technician, Paramedic | |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2020-01-06 |