| NPI | 1902834237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC TL39830) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: MI 4301044089) |
| 207P00000X Emergency Medicine (Licence: FL ME98696) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2016-07-19 |