| NPI | 1700059268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 46827) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 46827) |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2014-07-21 |