| 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 |