| NPI | 1992758411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 1441) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: WV 1441) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2024-01-25 |