| NPI | 1609154848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 58583) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: OK 5086) |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2023-03-13 |