| NPI | 1174594907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: WA MD00013280) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: WA MD00013280) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2011-12-06 |