| NPI | 1689810467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA1143) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: NV PA1143) |
| Enumeration Date | 2008-12-27 |
| Last Update Date | 2014-01-23 |