NPI | 1194216101 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.141973) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301501047) |
Enumeration Date | 2018-05-24 |
Last Update Date | 2021-11-04 |