| NPI | 1962792432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 1238) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 5274) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2019-02-06 |