| NPI | 1922382522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: OH 401264800711) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: OH 0085408) |
| Enumeration Date | 2011-10-01 |
| Last Update Date | 2011-10-01 |