| NPI | 1457111700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246RP1900X Technician, Pathology Phlebotomy (Licence: E6K2Z3J8) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: VT 106027) |
| Enumeration Date | 2024-03-21 |
| Last Update Date | 2024-03-21 |