| NPI | 1457749715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL M0985666) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL 0300738) |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2015-01-08 |