| NPI | 1003088931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: TX B1648501) |
| Additional Taxonomies | 376K00000X Nurse's Aide |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2008-04-01 |