| NPI | 1497748420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 221081-1) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: NY 221081-1) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2026-06-23 |