| NPI | 1679671176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 52150) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: CA G49088) |
| 207Q00000X Family Medicine (Licence: SC 52150) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2018-08-30 |