| NPI | 1245593581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 6880) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q3481) |
| 207Q00000X Family Medicine (Licence: TX Q3481) | |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: TX q3481) | |
| 208D00000X General Practice (Licence: TX q3481) | |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2022-07-06 |