| NPI | 1285690255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.007479) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101015920) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2020-07-09 |