| NPI | 1144603804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 58133) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 58133) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2019-10-24 |