| NPI | 1245403997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: AL B1427457) |
| Additional Taxonomies | 376K00000X Nurse's Aide |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2008-04-02 |