| NPI | 1952915373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: NC P112481) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: TX 737291) |
| 146L00000X Emergency Medical Technician, Paramedic (Licence: AZ P99148527) | |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2025-10-09 |