| NPI | 1871709782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 57493) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 57493) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: TN 57493) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2018-08-29 |