| NPI | 1235750092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 67447) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 67447) |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2024-05-22 |