| NPI | 1245128495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA RN95410104) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: CA E127217) |
| Enumeration Date | 2025-06-26 |
| Last Update Date | 2025-06-26 |