| NPI | 1568277176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: IL 060847886) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: IA PARA4001323) |
| Enumeration Date | 2025-02-11 |
| Last Update Date | 2025-02-12 |