NPI | 1720029275 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 36478) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 36478) |
207Q00000X Family Medicine (Licence: LA MD.13301R) | |
Enumeration Date | 2006-06-08 |
Last Update Date | 2025-05-22 |