| NPI | 1558443861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: ME MD14939) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: ME 014939) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2012-06-19 |