| NPI | 1447121801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: TX 727394) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: TX 23123) |
| 174H00000X Health Educator | |
| 183700000X Pharmacy Technician (Licence: TX 393604) | |
| Enumeration Date | 2025-09-17 |
| Last Update Date | 2025-09-17 |