| NPI | 1346314853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 25930) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301073837) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2023-03-07 |