| NPI | 1821260209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 26920) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M9083) |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2014-01-29 |