| NPI | 1831547546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146E00000X (Licence: TX 777325) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: TX 777325) |
| 174H00000X Health Educator | |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2025-10-08 |