| NPI | 1255447728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME97747) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01079292A) |
| 146D00000X Personal Emergency Response Attendant (Licence: WV 21971) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: FL FLME 97747) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2023-11-02 |