| NPI | 1427547868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: NC M5069030) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: TX E2057475) |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2019-03-11 |