| NPI | 1063659209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146D00000X Personal Emergency Response Attendant (Licence: TN 45100) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN MD0000045100) |
| 207P00000X Emergency Medicine (Licence: KY 42531) | |
| 207Q00000X Family Medicine (Licence: TN 45100) | |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2012-04-19 |