| NPI | 1326553397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: NC M8017105) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: NC P018898) |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2017-12-12 |