| NPI | 1194758540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 30495) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2014015848) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2014-11-20 |