| NPI | 1083289763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: DC NA0000605862) |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate (Licence: DC E3131816) |
| Enumeration Date | 2021-05-25 |
| Last Update Date | 2021-05-25 |