| NPI | 1073550752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 46583) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: OH 35046582) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2021-08-10 |