NPI | 1053869263 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: NY 447573) |
Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant (Licence: NY 592558) |
Enumeration Date | 2016-09-15 |
Last Update Date | 2024-10-23 |