| NPI | 1851988745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: NV 78707) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: NV CHW1-5089) |
| 175T00000X Peer Specialist (Licence: NV PRSS-INT-5020) | |
| Enumeration Date | 2020-12-25 |
| Last Update Date | 2023-03-19 |