| NPI | 1811936479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 40381) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AL 26995) |
| 208D00000X General Practice (Licence: TN 40381) | |
| 208D00000X General Practice (Licence: GA 56932) | |
| 208D00000X General Practice (Licence: MA 219880) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TN 40381) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: AL 26995) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2011-12-01 |