| NPI | 1457807174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: OR 133013) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: OH 0172647) |
| 146L00000X Emergency Medical Technician, Paramedic (Licence: MI 3201016056) | |
| 146L00000X Emergency Medical Technician, Paramedic (Licence: ND 134054) | |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |