| NPI | 1528216447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102203391) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 2691) |
| 207Q00000X Family Medicine (Licence: HI 1599) | |
| 208M00000X Hospitalist (Licence: TN 2681) | |
| 208M00000X Hospitalist (Licence: VA 0102203391) | |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2018-07-20 |