| NPI | 1417142159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 44318) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101243054) |
| 208M00000X Hospitalist (Licence: VA 0101243054) | |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2013-03-07 |