| NPI | 1679838742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301100876) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.131422) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2024-02-08 |