| NPI | 1710445259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: OH M5066222) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: NY 454020) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 454020) | |
| 2470A2800X Technician, Health Information, Assistant Record Technician | |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2019-06-11 |