NPI | 1639415193 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: VA E081610702) |
Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: PA 090599) |
Enumeration Date | 2013-01-02 |
Last Update Date | 2013-01-02 |