| NPI | 1083084743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: CA P35402) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: CO 047999) |
| 146L00000X Emergency Medical Technician, Paramedic (Licence: OH 168840) | |
| 146L00000X Emergency Medical Technician, Paramedic (Licence: HI EMTP 2118) | |
| 146L00000X Emergency Medical Technician, Paramedic (Licence: ND 133421) | |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2016-06-30 |