| NPI | 1619193026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.091903) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2009-03-06 |