| NPI | 1033959424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146M00000X Emergency Medical Technician, Intermediate (Licence: NV 83947) |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate (Licence: UT 2023039312) |
| Enumeration Date | 2024-05-31 |
| Last Update Date | 2024-05-31 |