| NPI | 1154610640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.124062) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301105193) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2024-03-21 |