| NPI | 1538966221 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: PA E3760614) |
| Enumeration Date | 2025-02-28 |
| Last Update Date | 2025-02-28 |