| NPI | 1609850148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 45753) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA 36252) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2025-11-25 |