| NPI | 1811477474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME151272) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant |
| 207P00000X Emergency Medicine (Licence: PR 24264) | |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2026-01-30 |