| NPI | 1912937467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PR 7492) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: PR 7492) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2015-06-01 |