| NPI | 1952716169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN DO0000003190) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO 4187) |
| 207R00000X Internal Medicine (Licence: TN DO0000003190) | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2022-07-21 |