| NPI | 1730775875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247200000X Technician, Other |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: MI 1573733) |
| Enumeration Date | 2020-12-14 |
| Last Update Date | 2020-12-14 |