NPI | 1730268186 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: PA 175427) |
Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: TX B1438157) |
Enumeration Date | 2006-11-06 |
Last Update Date | 2007-07-08 |