| 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 | 2017-02-05 |