| NPI | 1609255272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN MD0000058125) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 58125) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2023-06-28 |