| NPI | 1669430435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OK 14328) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 14328) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2010-07-06 |