| NPI | 1750769154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 57632) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MA 291511) |
| 208M00000X Hospitalist (Licence: TN 57632) | |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2025-03-26 |