| NPI | 1922047489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD7971) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 07971) |
| 207W00000X Ophthalmology (Licence: TN MD7971) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2013-09-05 |