| NPI | 1407834708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101010774) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.009776) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2022-10-18 |