| NPI | 1346964988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 372600000X Adult Companion (Licence: CA E181104) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: CA E181104) |
| Enumeration Date | 2022-09-28 |
| Last Update Date | 2025-09-11 |