| NPI | 1285996157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 32454) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OK 32454) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2024-04-29 |