| NPI | 1194232058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: VA B201400319) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: VA B201400319) | |
| Enumeration Date | 2018-01-01 |
| Last Update Date | 2018-01-01 |