| NPI | 1417453564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 21086) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 65574) |
| 207P00000X Emergency Medicine (Licence: OK 37792) | |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2022-04-13 |