| NPI | 1013987023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 2059) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 2059) |
| 208M00000X Hospitalist (Licence: VA 0102203098) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 6434) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2015-06-18 |