| NPI | 1871845958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: NV P8069772) |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate (Licence: NV I0712928) |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2012-10-12 |