| NPI | 1699133397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A15973) |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2022-08-08 |