| NPI | 1811488836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: GA 141253) |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate (Licence: GA A2018422) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2018-06-16 |