| NPI | 1023842937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: CT 32713) |
| 146N00000X Emergency Medical Technician, Basic (Licence: GA E032700) | |
| Enumeration Date | 2024-09-02 |
| Last Update Date | 2024-09-02 |