| NPI | 1265819544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301511700) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.133938) |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2024-08-19 |