| NPI | 1689908105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2011009345) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-13203) |
| 207P00000X Emergency Medicine (Licence: OK 35789) | |
| 207P00000X Emergency Medicine (Licence: KS 04-43277) | |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2024-05-17 |