| NPI | 1447589056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 26432) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 4826) |
| 207P00000X Emergency Medicine (Licence: FL OS18890) | |
| Enumeration Date | 2009-12-09 |
| Last Update Date | 2022-07-27 |