| NPI | 1295785145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146D00000X Personal Emergency Response Attendant (Licence: AZ 3162) |
| Additional Taxonomies | 2083A0300X Preventive Medicine Addiction Medicine (Licence: AZ 3162) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2021-08-04 |