| NPI | 1174294367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: CO Q181686) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: WY P-6428) |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2021-09-27 |