NPI | 1164450573 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 22319) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 22319) |
Enumeration Date | 2006-06-28 |
Last Update Date | 2024-10-22 |