| NPI | 1962814194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: MI 1911986) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2025-08-07 |