| NPI | 1467413682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 1474) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 3700) |
| 207Q00000X Family Medicine (Licence: OK 3700) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2024-05-13 |