| NPI | 1801359559 |
|---|---|
| Other Name | KEN WAYNE ROBERTS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME153623) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2022-04-02 |