NPI | 1639857824 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: M5120299) |
Additional Taxonomies | 1710I1003X Military Health Care Provider, Independent Duty Medical Technicians |
Enumeration Date | 2023-07-07 |
Last Update Date | 2023-07-07 |