| NPI | 1235202003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN MD39402) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TN MD39402) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TN 39402) | |
| 207R00000X Internal Medicine (Licence: TN 39402) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2023-03-07 |