| NPI | 1164827259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL M8056537) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL 0200024) |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2014-10-31 |