| NPI | 1013228592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME142076) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: AZ 45685) |
| 207P00000X Emergency Medicine (Licence: AZ 45685) | |
| 207Q00000X Family Medicine (Licence: PA MT209273) | |
| 207Q00000X Family Medicine (Licence: FL ME142076) | |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2020-05-18 |