NPI | 1518980580 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 25607) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY R0950) |
Enumeration Date | 2006-07-25 |
Last Update Date | 2024-10-22 |