NPI | 1417086547 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: TN 44878) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 44878) |
208M00000X Hospitalist (Licence: TN 44878) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2007-03-05 |
Last Update Date | 2024-01-10 |