| NPI | 1013388206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146D00000X Personal Emergency Response Attendant |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic |
| 172A00000X Driver | |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2016-05-24 |