| NPI | 1275995201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 69150) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D97947) |
| 207P00000X Emergency Medicine (Licence: OH 57.028406) | |
| 207P00000X Emergency Medicine (Licence: OH 35135964) | |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2024-01-04 |