| NPI | 1609403096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: RI EMT15246-P) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: MA P0903270) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2020-03-25 |