NPI | 1811964232 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA14579) |
Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: CA P00762) |
Enumeration Date | 2006-03-03 |
Last Update Date | 2015-07-27 |