| NPI | 1962422592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL ME62390) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: FL ME62390) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2024-06-19 |