| NPI | 1013055920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146D00000X Personal Emergency Response Attendant (Licence: KY 13780) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 13780) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2015-01-29 |