| NPI | 1407243454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 34726) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R4179) |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2019-07-15 |