| NPI | 1922000918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN MD0000037436) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 37436) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2023-03-07 |