| NPI | 1497645824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: CO Q242651) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: CO 737812731541) |
| 146N00000X Emergency Medical Technician, Basic (Licence: CO E3877964) | |
| Enumeration Date | 2025-07-07 |
| Last Update Date | 2025-07-07 |