| NPI | 1417995739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 26443) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: KY 26443) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2018-02-12 |