NPI | 1760422943 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 25897) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 25897) |
Enumeration Date | 2006-06-07 |
Last Update Date | 2024-02-02 |