NPI | 1942686340 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: WA LP00046949) |
Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: E1381578) |
Enumeration Date | 2015-08-07 |
Last Update Date | 2015-08-07 |