| NPI | 1871578740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60041375) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: CA C42852) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2010-08-18 |