| NPI | 1497208581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20392) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 0139R) |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2022-10-17 |