NPI | 1801835947 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 55281) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 55281) |
207P00000X Emergency Medicine (Licence: FL ME92005) | |
Enumeration Date | 2006-06-05 |
Last Update Date | 2025-09-30 |