| NPI | 1366799256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 37065) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 12506111) |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2020-11-10 |