| NPI | 1942066899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WS0200X Registered Nurse, School (Licence: MI 4704342349) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: MI 1519070) |
| Enumeration Date | 2024-02-27 |
| Last Update Date | 2024-02-27 |