| NPI | 1215901517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL MD.32254) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101260105) |
| 207Q00000X Family Medicine (Licence: TN 29616) | |
| 208M00000X Hospitalist (Licence: VA 0101260105) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2022-12-29 |