| NPI | 1497774293 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 25486) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 27166) | 
| Enumeration Date | 2006-07-19 | 
| Last Update Date | 2014-05-20 |