| NPI | 1710407937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 6356) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 6356) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2023-08-25 |