| NPI | 1386816544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN TN45903) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN TN45903) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2022-04-03 |