| NPI | 1558680207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146M00000X Emergency Medical Technician, Intermediate (Licence: NE 2859) |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate (Licence: IA I-12-317-12) |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2010-05-20 |