| NPI | 1811671043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC LL92367) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: TX 701710) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-06-08 |
| Last Update Date | 2025-02-24 |