NPI | 1225874563 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: CA E178095) |
Enumeration Date | 2024-07-05 |
Last Update Date | 2024-07-05 |