| NPI | 1992771059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL 8832959) |
| Additional Taxonomies | 163WE0003X Registered Nurse Emergency (Licence: AL 1-064101) |
| 363LF0000X Nurse Practitioner Family (Licence: AL 1-064101) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2007-07-09 |