| NPI | 1083622575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN MD0000031405) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 31405) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2016-08-15 |