| NPI | 1417126822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: MO 1790001) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: MO 179001) |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2008-02-29 |