| NPI | 1780974246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101019751) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.016641) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2023-10-26 |