| NPI | 1144224783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN MD38948) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101055839) |
| 207P00000X Emergency Medicine (Licence: TN 38948) | |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2014-06-04 |