| NPI | 1932172103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 53049) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 24752) |
| 207Q00000X Family Medicine (Licence: KY 53049) | |
| 208M00000X Hospitalist (Licence: TN 24752) | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2024-02-26 |