| NPI | 1376712935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 32576) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301090607) |
| 207P00000X Emergency Medicine (Licence: MO 2011001438) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MO 2011001438) | |
| 207P00000X Emergency Medicine (Licence: TX Q0887) | |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2016-11-03 |