| NPI | 1740381292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2020042510) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.013655) |
| 207P00000X Emergency Medicine (Licence: IN 02004972A) | |
| 207PE0004X Emergency Medicine Emergency Medical Services (Licence: MI 009300) | |
| 207P00000X Emergency Medicine (Licence: MI 5101009300) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2024-10-24 |