| NPI | 1508057159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 43198) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 43198) |
| 208M00000X Hospitalist (Licence: TN 43198) | |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2020-06-05 |