| NPI | 1275761330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL M0834453) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL 8936874) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2015-03-17 |