| NPI | 1023538477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL M8046770) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL 0800815) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2022-07-21 |