| NPI | 1487236592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 71843) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 71843) |
| 208D00000X General Practice (Licence: TN 71843) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-27 |
| Last Update Date | 2024-11-01 |