| NPI | 1104414507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: FL PMD536992) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: IL P000366989) |
| Enumeration Date | 2021-01-02 |
| Last Update Date | 2021-01-02 |