| NPI | 1609824366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 25517) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 20884) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2014-12-19 |