| NPI | 1174954929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic |
| 146M00000X Emergency Medical Technician, Intermediate | |
| Enumeration Date | 2013-12-04 |
| Last Update Date | 2013-12-04 |