| NPI | 1679715742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 17508) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: PR 17508) |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2021-12-10 |