| NPI | 1841379609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN MD012570TN) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC MD9700433NC) |
| 207Q00000X Family Medicine (Licence: TN MD012570TN) | |
| 207Q00000X Family Medicine (Licence: NC MD9700433NC) | |
| 207R00000X Internal Medicine (Licence: TN MD012570TN) | |
| 207R00000X Internal Medicine (Licence: NC MD9700433NC) | |
| 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: TN MD012570TN) | |
| 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: NC MD9700433NC) | |
| 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: TN MD012570TN) | |
| 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: NC MD9700433NC) | |
| 208D00000X General Practice (Licence: TN MD012570TN) | |
| 208D00000X General Practice (Licence: NC MD9700433NC) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2007-07-08 |