| NPI | 1033347075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 48502) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: KY 48502) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2022-03-24 |