| NPI | 1588458996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: 4710-4076-4745) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: LA 4710-4076-4745) |
| Enumeration Date | 2025-04-09 |
| Last Update Date | 2025-04-09 |