| NPI | 1356874358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.138724) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301501790) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2022-04-05 |