| NPI | 1285690032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AZ 20137) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: AZ 20137) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2015-09-28 |