| NPI | 1881768281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 42882) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 42882) |
| 207Q00000X Family Medicine (Licence: NE 19348) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2019-07-17 |