| NPI | 1225018757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OK 3054) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OK 3054) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2023-08-22 |