| NPI | 1871629931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN MD46590) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 10356R) |
| 208M00000X Hospitalist (Licence: TN 46590) | |
| Enumeration Date | 2007-02-25 |
| Last Update Date | 2021-05-12 |