| NPI | 1972690618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 75647) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: MA 75647) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2008-04-30 |