| NPI | 1396064499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.123702) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301097245) |
| Enumeration Date | 2010-05-28 |
| Last Update Date | 2022-03-07 |