| NPI | 1740348127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 88893) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301078778) |
| 207P00000X Emergency Medicine (Licence: NY 214923) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2022-06-15 |