| NPI | 1316924616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35060544) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: OH 35060544) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2008-09-30 |