| NPI | 1598727380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD019054) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 51283) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TN MD019054) | |
| 207Q00000X Family Medicine (Licence: AZ 51283) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2022-10-07 |