| NPI | 1003683699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: NY 477779) |
| 146N00000X Emergency Medical Technician, Basic (Licence: E3513558) | |
| 146N00000X Emergency Medical Technician, Basic (Licence: MA E0917112) | |
| Enumeration Date | 2023-12-05 |
| Last Update Date | 2023-12-05 |