| NPI | 1922049063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN MD29917) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 29917) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2008-01-23 |