| NPI | 1205886439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: OH 35.068339) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: OH 35068339) |
| 207P00000X Emergency Medicine (Licence: OH 35068339) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-03-24 |