| NPI | 1871581512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 20226) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 20226) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2024-01-17 |