| NPI | 1285682849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 25066) |
| Additional Taxonomies | 207RA0000X Internal Medicine Adolescent Medicine (Licence: TN MD0000025066) |
| 208000000X Pediatrics (Licence: TN 25066) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2023-05-11 |