| NPI | 1669886594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 60565) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 27516) |
| 207Q00000X Family Medicine (Licence: AZ 54499) | |
| 208M00000X Hospitalist (Licence: AZ 54499) | |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2020-04-03 |