| NPI | 1750335055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 36565) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 30285) |
| 207P00000X Emergency Medicine (Licence: KY 37548) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: IN 01049225A) | |
| 207Q00000X Family Medicine (Licence: FL ME 97720) | |
| 207Q00000X Family Medicine (Licence: KY 37548) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2020-06-26 |