| NPI | 1609599851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate |
| Enumeration Date | 2022-09-22 |
| Last Update Date | 2022-09-22 |