| NPI | 1558787143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 5806) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207P00000X Emergency Medicine (Licence: KS 05-38564) | |
| 207P00000X Emergency Medicine (Licence: AR E-9478) | |
| Enumeration Date | 2014-03-07 |
| Last Update Date | 2017-04-29 |