| NPI | 1992726590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 1024454) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: OH 50000636) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2015-02-27 |