| NPI | 1770721581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA VN 190911) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: CA B1051553) |
| Enumeration Date | 2009-02-02 |
| Last Update Date | 2009-02-02 |