| NPI | 1013987288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OK 3826) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.004602) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OK 3826) | |
| 207Q00000X Family Medicine (Licence: OK 3826) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2022-09-26 |