NPI | 1174285092 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171000000X Military Health Care Provider |
Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: TX E1840660) |
Enumeration Date | 2021-10-07 |
Last Update Date | 2021-10-07 |