| NPI | 1790419620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: TN 250424) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: TN 34373) |
| Enumeration Date | 2022-07-15 |
| Last Update Date | 2022-07-15 |