NPI | 1770711517 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL P0990483) |
Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL 0400030) |
Enumeration Date | 2009-07-01 |
Last Update Date | 2009-07-01 |