| NPI | 1316099237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 14525) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: PR 14525) |
| 261QH0100X Clinic/Center, Health Services (Licence: PR 14525) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2014-06-18 |