| NPI | 1770282048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 084904-23) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: MA 828457) |
| 146L00000X Emergency Medical Technician, Paramedic (Licence: NH P16393) | |
| 163WE0003X Registered Nurse, Emergency (Licence: NH 084904-21) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN10004231) | |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2024-03-26 |