| NPI | 1205152105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN MD0000049325) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN MD0000049325) |
| Enumeration Date | 2010-04-16 |
| Last Update Date | 2022-07-07 |