| NPI | 1962590968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 20090014870) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 4415) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2015-07-30 |