| NPI | 1962206334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: OH RN.471242) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2025-04-03 |
| Last Update Date | 2025-05-06 |