NPI | 1316339401 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL M8059892) |
Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL 0700915) |
Enumeration Date | 2015-02-26 |
Last Update Date | 2015-02-26 |