| NPI | 1487642039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 26877) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 1410) |
| 207Q00000X Family Medicine (Licence: AL 15437) | |
| 207P00000X Emergency Medicine (Licence: TN MD0000026877) | |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2024-01-29 |