| NPI | 1629362132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 70138) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P8852) |
| 207R00000X Internal Medicine (Licence: TN 51759) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TN Internal Medicine) | |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2019-12-19 |