| NPI | 1477585545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN MD20100) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 20100) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2011-04-04 |