| NPI | 1780222786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic |
| Additional Taxonomies | 247200000X Technician, Other |
| 2472E0500X Technician, Other, EEG | |
| Enumeration Date | 2019-12-20 |
| Last Update Date | 2019-12-20 |