| NPI | 1598709727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD0000038182) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 38182) |
| 208M00000X Hospitalist (Licence: TN 38182) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2014-06-10 |