NPI | 1962750323 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 72978) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 076754) |
Enumeration Date | 2012-08-16 |
Last Update Date | 2025-04-25 |