| NPI | 1316941230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: TN MD15549) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101029932) |
| 207Q00000X Family Medicine (Licence: TN 15549) | |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2019-12-30 |