| NPI | 1003605692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA P42872) |
| Enumeration Date | 2025-05-01 |
| Last Update Date | 2026-03-05 |