| NPI | 1285069500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 0369R) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: OK 63898) |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2021-06-22 |