| NPI | 1992445738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.017794) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151015493) |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2025-06-26 |