| NPI | 1053341453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: OK 23901) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 23901) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2024-05-29 |