| NPI | 1639790173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: NY 251056) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 251056) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 251056) | |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2020-05-06 |