| NPI | 1043399975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60062980) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: OR MD25749) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2010-09-10 |