| NPI | 1790542439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: FL EMT570074) |
| Enumeration Date | 2024-02-29 |
| Last Update Date | 2024-02-29 |