| NPI | 1700325487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.014102) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 02006224A) |
| 207P00000X Emergency Medicine (Licence: MI EMC0004670) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 34014102) | |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2024-03-21 |