| NPI | 1053338723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34002560) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: OH 34002560) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2015-01-20 |