| NPI | 1508180373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 070009) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 146D00000X Personal Emergency Response Attendant (Licence: KY 207P00000X) | |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2014-10-28 |