| NPI | 1548365778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 65244) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 21710) |
| 208M00000X Hospitalist (Licence: TN 21710) | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2022-01-26 |