| NPI | 1467880203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant |
| 146L00000X Emergency Medical Technician, Paramedic | |
| 146M00000X Emergency Medical Technician, Intermediate | |
| Enumeration Date | 2013-10-14 |
| Last Update Date | 2013-10-14 |