| NPI | 1053676288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM MD2022-1461) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2022-1461) |
| 207R00000X Internal Medicine (Licence: KY 48294) | |
| 208M00000X Hospitalist (Licence: KY 48294) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2024-01-05 |