| NPI | 1215994868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 15810) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OK 15810) |
| 207P00000X Emergency Medicine (Licence: OK 15810) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2017-05-02 |