NPI | 1306080296 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1710I1003X Military Health Care Provider, Independent Duty Medical Technicians |
Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: NV P8033950) |
Enumeration Date | 2009-04-23 |
Last Update Date | 2009-04-23 |