| NPI | 1346620515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL P0843282) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL 9142213) |
| 146L00000X Emergency Medical Technician, Paramedic (Licence: FL PMD 504315) | |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2015-06-03 |