| NPI | 1588985923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: MI 207N00000X) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301092115) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2019-07-17 |