| NPI | 1740770759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 63856) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 010100) |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2022-08-04 |