| NPI | 1841800943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 66241) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: ID 16540) |
| 163W00000X Registered Nurse (Licence: ID 44491) | |
| 163WF0300X Registered Nurse, Flight (Licence: ID 44491) | |
| 363LF0000X Nurse Practitioner, Family (Licence: ID 66241) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MT 226070) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2024-08-29 |