| NPI | 1912999418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 31076) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: AZ 31076) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2015-07-28 |