| NPI | 1083691901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34-007289) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: OH 34007289) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2013-03-27 |