| NPI | 1023786753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: FL PMD509708) |
| Additional Taxonomies | 174H00000X Health Educator |
| 172V00000X Community Health Worker (Licence: FL CCHW100372) | |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2021-08-30 |