| NPI | 1336327394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247200000X |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: CA B1688832) |
| 146N00000X Emergency Medical Technician, Basic (Licence: MN 941375) | |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2017-04-02 |