| NPI | 1235603432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 4151) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TN 4151) |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2022-07-09 |