| NPI | 1962919126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: E3190371) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: GA 5289) |
| 183700000X Pharmacy Technician (Licence: 10050913) | |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2018-01-09 |