| NPI | 1932400066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: AL 0700723) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: GA 9096) |
| Enumeration Date | 2010-11-05 |
| Last Update Date | 2011-01-10 |