| NPI | 1780475277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate (Licence: NC P530638) |
| 146M00000X Emergency Medical Technician, Intermediate (Licence: VA C202504081) | |
| Enumeration Date | 2025-05-14 |
| Last Update Date | 2025-07-30 |