| NPI | 1295730281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD0000016257) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 16257) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2021-07-20 |