| NPI | 1154344703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35054874) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: MA 71198) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2019-10-23 |