| NPI | 1336143163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD 37808) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101232193) |
| 208M00000X Hospitalist (Licence: TN 37808) | |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2011-08-17 |