| NPI | 1144494360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301088075) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.127868) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2023-06-20 |