| NPI | 1104403443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: FL 543369) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: FL ME161108) | |
| 208D00000X General Practice (Licence: FL ME161108) | |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2023-12-05 |