| NPI | 1578542726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 00-25375) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: NC 00-25375) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 098717-1) | |
| Enumeration Date | 2006-01-14 |
| Last Update Date | 2013-10-07 |