| NPI | 1467413856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801102724) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301071109) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301071109) | |
| 207PH0002X Emergency Medicine, Hospice and Palliative Medicine (Licence: MI 4301071109) | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2020-02-24 |