| NPI | 1598706830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 14146) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: PR 14146) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2014-08-23 |