| NPI | 1841400389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301087961) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35C.004194) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2026-05-29 |