| NPI | 1902057599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: MD R156408) |
| Additional Taxonomies | 163WF0300X Registered Nurse, Flight (Licence: MD R156408) |
| Enumeration Date | 2008-10-01 |
| Last Update Date | 2008-10-01 |