| NPI | 1588534168 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: CA E187235) |
| Enumeration Date | 2025-11-07 |
| Last Update Date | 2026-02-12 |