| NPI | 1780246587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.015807) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101026030) |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2024-04-11 |