| NPI | 1245222587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 226342) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: 226342-1) |
| 208D00000X General Practice (Licence: NY 226342) | |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2019-06-07 |