| NPI | 1114313319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 57824) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 57824) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: TN 57824) | |
| 208M00000X Hospitalist (Licence: TN 57824) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2023-02-23 |