| NPI | 1447379987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OK 17441) |
| Additional Taxonomies | 208D00000X General Practice (Licence: LA 332149) |
| 208D00000X General Practice (Licence: TX H4163) | |
| 207Q00000X Family Medicine (Licence: OK 17441) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OK 17441) | |
| 208D00000X General Practice (Licence: AR E-15344) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2026-06-25 |