| NPI | 1447414131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI L1377451) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.125227) |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2023-01-18 |