| NPI | 1609895366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 067036) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: CT 033223) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2012-05-24 |