| NPI | 1043474000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: AL E1604034) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: AL 9142973) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2015-04-06 |