| NPI | 1558693135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146D00000X Personal Emergency Response Attendant (Licence: NY 259140318) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 259140318) |
| 152WP0200X Optometrist, Pediatrics (Licence: NY 259140318) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 259140318) | |
| Enumeration Date | 2010-02-05 |
| Last Update Date | 2010-02-05 |