| NPI | 1992576730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: VA C201503065) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: VA C201503065) |
| Enumeration Date | 2024-01-10 |
| Last Update Date | 2024-01-10 |