| NPI | 1790554921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: PA 156588) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 235500000X Specialist/Technologist | |
| 374700000X Technician | |
| Enumeration Date | 2023-12-28 |
| Last Update Date | 2023-12-28 |