NPI | 1023425501 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 63360) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2017022846) |
208M00000X Hospitalist (Licence: TN 63360) | |
208M00000X Hospitalist (Licence: NC 2019-01661) | |
Enumeration Date | 2014-07-17 |
Last Update Date | 2024-02-12 |