| NPI | 1124066444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 29737) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: KY 29737) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2023-06-07 |