| NPI | 1710957469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD26140) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD26140) |
| 207R00000X Internal Medicine (Licence: TN MD28876) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2021-07-19 |