| NPI | 1942462098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 49747) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 49747) |
| 207R00000X Internal Medicine (Licence: NC 160116) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2016-05-18 |