| NPI | 1346205929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 0428121) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 44600) |
| 207Q00000X Family Medicine (Licence: KS 04-28121) | |
| 207Q00000X Family Medicine (Licence: OK 44600) | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2025-01-31 |