| NPI | 1699208421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 68347) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 68347) |
| 208000000X Pediatrics (Licence: TN 68347) | |
| Enumeration Date | 2017-04-08 |
| Last Update Date | 2024-11-12 |