| NPI | 1093179111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 61657) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 063879) |
| 208M00000X Hospitalist (Licence: TN 61657) | |
| 208M00000X Hospitalist (Licence: CT 063879) | |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2021-01-22 |