| NPI | 1952386690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247200000X Technician, Other |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: CA B0415118) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2025-09-11 |