| NPI | 1457343394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 24774) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 24774) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2018-02-09 |