NPI | 1407386261 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: TX M5015599) |
Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL 1400867) |
Enumeration Date | 2017-06-14 |
Last Update Date | 2022-07-21 |