| NPI | 1588645899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-34198) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.40789) |
| 207Q00000X Family Medicine (Licence: TN MD37608) | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2020-06-23 |