| NPI | 1306610035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: MT MED-PARA-LIC-52339) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: MT MED-EMT-LIC-68132) |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2023-11-13 |