| NPI | 1740275221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 37163) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN MD37163) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: TN 37163) | |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2025-12-10 |