| NPI | 1912434416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.138719) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4351039441) |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2020-06-22 |