NPI | 1801203344 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 30894) |
Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: OK 30894) |
Enumeration Date | 2014-07-16 |
Last Update Date | 2021-05-21 |