| NPI | 1346827334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301511446) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.151302) |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2024-08-08 |