NPI | 1710621479 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: NY 461860) |
Additional Taxonomies | 246RP1900X Technician, Pathology Phlebotomy (Licence: NY 041122) |
Enumeration Date | 2022-04-27 |
Last Update Date | 2022-04-27 |