| NPI | 1194926485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD23279) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: OR MD23279) |
| 208000000X Pediatrics (Licence: OR MD23279) | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2023-03-07 |