| NPI | 1528838497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: PA 1045827) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PA E3783305) |
| Enumeration Date | 2024-01-03 |
| Last Update Date | 2024-01-03 |