| NPI | 1538131701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 20277) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: CO 20277) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2007-07-08 |