| NPI | 1003159690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 29836) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 04-38354) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2016-12-15 |