| NPI | 1538587316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 5725) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207P00000X Emergency Medicine (Licence: KS 05-38741) | |
| 207P00000X Emergency Medicine (Licence: MO 2016016167) | |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2018-07-10 |