| NPI | 1144649203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101023670) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 012647) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2026-10-05 |