| NPI | 1780793562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 146D00000X Personal Emergency Response Attendant (Licence: PR 16409) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 16409) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2016-07-27 |