| NPI | 1164843975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: NJ 606731) |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate (Licence: CT 94-200) |
| 146N00000X Emergency Medical Technician, Basic (Licence: CT 85-393) | |
| Enumeration Date | 2013-12-20 |
| Last Update Date | 2021-01-26 |