| NPI | 1952355026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 1442) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 2671) |
| 207P00000X Emergency Medicine (Licence: TN DO0000001442) | |
| Enumeration Date | 2006-05-21 |
| Last Update Date | 2025-12-03 |