| NPI | 1770521940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD34779) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 34779) |
| 207R00000X Internal Medicine (Licence: TN 34779) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2024-04-17 |