| NPI | 1770927931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.133492) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301103660) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2019-06-04 |