NPI | 1295221828 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: E3186338) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: 2000026089) |
Enumeration Date | 2018-07-06 |
Last Update Date | 2018-07-06 |