| NPI | 1225455371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.015323) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101021255) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2025-07-01 |