| NPI | 1487680393 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A69360) | 
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic | 
| 3416L0300X Ambulance, Land Transport | |
| 261QU0200X Clinic/Center, Urgent Care | |
| 261QE0002X Clinic/Center, Emergency Care | |
| 146L00000X Emergency Medical Technician, Paramedic | |
| 146M00000X Emergency Medical Technician, Intermediate | |
| 363A00000X Physician Assistant | |
| 207Q00000X Family Medicine (Licence: CA A69390) | |
| Enumeration Date | 2006-06-23 | 
| Last Update Date | 2015-03-25 |