| NPI | 1407868607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX L2803) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: TX L2803) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2015-03-11 |