| NPI | 1780561415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: CA E208896) |
| Additional Taxonomies | 372600000X Adult Companion |
| Enumeration Date | 2025-08-15 |
| Last Update Date | 2025-08-15 |