| NPI | 1487662219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN DO1659) |
| Additional Taxonomies | 207QG0300X Family Medicine Geriatric Medicine (Licence: PA OS006544L) |
| 208600000X Surgery (Licence: PA OS006544L) | |
| 208D00000X General Practice (Licence: PA OS006544L) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2018-01-10 |