| NPI | 1710925847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 32012) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN TN32012) |
| 207R00000X Internal Medicine (Licence: KY TP571) | |
| 208M00000X Hospitalist (Licence: TN 32012) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2021-02-08 |