| NPI | 1134814023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: FL PMD200769) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: FL EMT84124) |
| Enumeration Date | 2023-04-07 |
| Last Update Date | 2023-04-07 |