| NPI | 1396734646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 3224) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: FL OS11746) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2023-03-07 |