| NPI | 1891746541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 52680) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: AZ 28351) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2015-06-09 |