| NPI | 1841629375 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 58936) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 127658) |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2019-12-09 |