| NPI | 1417310947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U1967) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 04-40707) |
| 207P00000X Emergency Medicine (Licence: OK 32233) | |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2024-04-08 |