| NPI | 1427055714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA c167574) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: OH 35.082833) |
| 207Q00000X Family Medicine (Licence: OH 35082833F) | |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2020-02-28 |