| NPI | 1750812186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: KS 48792) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: E1632587) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2017-03-27 |