| NPI | 1174837546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: PR 18514) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PR 28054) |
| 146D00000X Personal Emergency Response Attendant (Licence: PR 18514) | |
| 282NC0060X General Acute Care Hospital, Critical Access (Licence: PR 18514) | |
| 282NC2000X General Acute Care Hospital, Children (Licence: PR 18514) | |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2014-09-23 |