| NPI | 1598933806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL M0832842) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL 8731508) |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2015-03-24 |