| NPI | 1851337893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 19458) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TN MD19458) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2013-05-29 |