| NPI | 1578593620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: TN 23857) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 23857) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2015-08-21 |