| NPI | 1497124507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OT021635) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: ND 124368) |
| 146L00000X Emergency Medical Technician, Paramedic (Licence: MN 955973) | |
| 146L00000X Emergency Medical Technician, Paramedic (Licence: MT MED-PARA-LIC-35789) | |
| 146L00000X Emergency Medical Technician, Paramedic (Licence: OR 202555) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2023-09-09 |