| NPI | 1508842568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35063604) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: OH 35063604) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2014-06-05 |