| NPI | 1518969468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 31909) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME161926) |
| 207Q00000X Family Medicine (Licence: TN 31909) | |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2023-05-11 |