| NPI | 1952356206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD40980) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 40980) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2018-09-04 |