| NPI | 1497067607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P8816) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 21750) |
| 207P00000X Emergency Medicine (Licence: OK 30861) | |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2014-09-11 |