| NPI | 1235146713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 17278) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX J8925) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2022-10-03 |