| NPI | 1235592205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 59638) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 59638) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2020-11-16 |