| NPI | 1891288619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.142247) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4351029794) |
| 207P00000X Emergency Medicine (Licence: MI 4301504487) | |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2021-06-29 |