| NPI | 1326007113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 42748) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 00023125) |
| 207Q00000X Family Medicine (Licence: TN MD0000042748) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2012-07-26 |