| NPI | 1134175037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: UT 277544-1205) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: UT 277544-1205) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2024-08-30 |