NPI | 1316567191 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 65124) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 65124) |
207R00000X Internal Medicine (Licence: TN 65124) | |
208000000X Pediatrics (Licence: TN 65124) | |
208100000X Physical Medicine & Rehabilitation (Licence: TN 65124) | |
2085R0202X Radiology Diagnostic Radiology (Licence: TN 65124) | |
208600000X Surgery (Licence: TN 65124) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-04-21 |
Last Update Date | 2024-06-07 |