| NPI | 1942000609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: MD 0022704) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: M5073861) |
| Enumeration Date | 2025-03-13 |
| Last Update Date | 2025-03-13 |