| NPI | 1811914641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.039554) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: OH 35039554) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2016-07-08 |