| NPI | 1154766764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 54363) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 54363) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2016-08-04 |