| NPI | 1376331058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: PA 096491) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PA 096491) |
| Enumeration Date | 2025-04-30 |
| Last Update Date | 2025-04-30 |