| NPI | 1093339236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.148150) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4351046622) |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2025-02-12 |