| NPI | 1326465691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 56247) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 26102) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2019-02-14 |