| NPI | 1992929319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TN 45524) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: TN 45524) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: TN 45524) | |
| 208000000X Pediatrics (Licence: TN 45524) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2013-06-25 |