| NPI | 1689808016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 39773) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 0433880) |
| 207P00000X Emergency Medicine (Licence: FL ME34421) | |
| 207P00000X Emergency Medicine (Licence: KY TP404) | |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2022-08-01 |