| NPI | 1811935612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TN 41017) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN MD41017) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2018-03-17 |