| NPI | 1417443466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102208012) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 0255R) |
| 207P00000X Emergency Medicine (Licence: OK 6735) | |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2023-08-22 |