| NPI | 1972771293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: AL E0298474) |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate (Licence: AL 8834260) |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2015-04-14 |