| NPI | 1255698247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146D00000X Personal Emergency Response Attendant (Licence: LA MD.208212) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: MS 24046) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2016-09-21 |