| NPI | 1710349543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.143562) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301509387) |
| 207P00000X Emergency Medicine (Licence: FL ME134693) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2023-06-29 |