| NPI | 1962382838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: TN 212427) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: KY 1127417) |
| Enumeration Date | 2025-09-03 |
| Last Update Date | 2025-09-03 |