| NPI | 1982620985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 9700780) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 37576) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2022-03-17 |