| NPI | 1326707480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: CA P32875) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: CA 22-CCHW-00000) |
| 146E00000X (Licence: CA 377) | |
| Enumeration Date | 2021-12-15 |
| Last Update Date | 2025-11-02 |