| NPI | 1285643213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA15978) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: CA PA15978) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2019-04-09 |