NPI | 1205147998 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OK 6118) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 6118) |
207Q00000X Family Medicine (Licence: AR 18608) | |
Enumeration Date | 2010-06-28 |
Last Update Date | 2025-07-15 |