| NPI | 1902078041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 44755) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 002535) |
| 207P00000X Emergency Medicine (Licence: TN 44755) | |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2017-03-16 |