| NPI | 1316520521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101027934) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 02008191A) |
| 207P00000X Emergency Medicine (Licence: OH 34.017683) | |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2025-03-03 |