| NPI | 1093988008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 45650) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN MD0000045650) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2020-09-09 |