| NPI | 1396634713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 156F00000X Technician/Technologist |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: FL E3775585) |
| Enumeration Date | 2025-07-01 |
| Last Update Date | 2025-07-01 |