| NPI | 1508202938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301513959) |
| Additional Taxonomies | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: OH 35.130846) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2025-07-16 |