| NPI | 1912702069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: SC 214250) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: SC SC023349) |
| Enumeration Date | 2025-02-13 |
| Last Update Date | 2025-02-13 |