| NPI | 1629370879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: FL EMT540925) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: FL RPT37) |
| Enumeration Date | 2010-11-20 |
| Last Update Date | 2014-03-31 |