| NPI | 1235169632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 2436) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2024045789) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2025-02-25 |