| NPI | 1780979211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 50198) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: GA 071481) |
| 208M00000X Hospitalist (Licence: TN 50198) | |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2017-01-09 |