| NPI | 1699944330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL M0848863) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL 8628241) |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2015-04-15 |