| NPI | 1538229497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146D00000X Personal Emergency Response Attendant (Licence: VA 0101046274) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: VA 0101046274) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2023-06-14 |