| NPI | 1912991472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME85447) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: TX k4915) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2009-06-01 |