| NPI | 1588126684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 26592) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 34925) |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2025-02-11 |