| NPI | 1992148407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 29830) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-9835) |
| 207P00000X Emergency Medicine (Licence: KS 04-38054) | |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2017-01-18 |