| NPI | 1760083224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 45340) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2023-03463) |
| Enumeration Date | 2020-11-02 |
| Last Update Date | 2025-11-25 |