| NPI | 1912167008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 29490) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N7838) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2016-09-12 |