| NPI | 1861432130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: PR 15133) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: PR 15133) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2014-04-17 |