| NPI | 1730706219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 7395) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OK 7395) |
| 207P00000X Emergency Medicine (Licence: OK 7395) | |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2023-11-17 |