| NPI | 1205896834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN MD15244) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101249990) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2014-06-11 |