| NPI | 1467540096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA07238) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2019-09-19 |