| NPI | 1982973525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: NC P039485) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: SC SC014421) |
| Enumeration Date | 2011-12-28 |
| Last Update Date | 2011-12-28 |