NPI | 1619383270 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL M8040279) |
Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL 0500174) |
Enumeration Date | 2014-07-03 |
Last Update Date | 2014-07-03 |