| NPI | 1114172376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TN MD0000047094) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2023-01-24 |