| NPI | 1649344839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 20362) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 20362) |
| 207V00000X Obstetrics & Gynecology (Licence: OK 20362) | |
| 208600000X Surgery (Licence: OK 20362) | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2022-10-25 |