| NPI | 1003057068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: TN 46691) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 46691) |
| 208M00000X Hospitalist (Licence: TN 46691) | |
| Enumeration Date | 2009-03-20 |
| Last Update Date | 2018-10-30 |