NPI | 1407024862 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL M0832832) |
Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL 8524183) |
Enumeration Date | 2008-02-19 |
Last Update Date | 2015-03-09 |