| NPI | 1982131660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 60650) |
| Additional Taxonomies | 2279P1006X Respiratory Therapist, Registered, Pulmonary Function Technologist (Licence: CA 34223) |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2025-07-23 |