| NPI | 1841150034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WF0300X Registered Nurse, Flight (Licence: CO 0184227) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 732637) |
| Enumeration Date | 2025-11-12 |
| Last Update Date | 2025-11-12 |