| NPI | 1144812165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 102938) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: GA P032535) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-02-10 |
| Last Update Date | 2025-01-28 |