| NPI | 1346248879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 22027) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101253059) |
| 207V00000X Obstetrics & Gynecology (Licence: VA 0101253059) | |
| 207V00000X Obstetrics & Gynecology (Licence: SC 83695) | |
| 207V00000X Obstetrics & Gynecology (Licence: TN MD22027) | |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2025-09-24 |