NPI | 1396368361 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 246YR1600X Spec/Tech, Health Info, Registered Record Administrator |
Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic |
171000000X Military Health Care Provider | |
Enumeration Date | 2020-05-25 |
Last Update Date | 2022-05-22 |