| NPI | 1134249642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M4805) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: TX M4805) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2021-06-29 |