| NPI | 1669799532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 55472) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 67110) |
| 207P00000X Emergency Medicine (Licence: GA 67110) | |
| Enumeration Date | 2010-04-30 |
| Last Update Date | 2021-04-30 |