| NPI | 1154399665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35-064661) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: OH 35064661) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2018-06-28 |