| NPI | 1235146036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: OK 25130) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 25130) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2021-06-23 |