| NPI | 1598725111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 22018) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 22018) |
| 207Q00000X Family Medicine (Licence: AR E-14312) | |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2023-04-14 |