| NPI | 1053688549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2020-00269) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207Q00000X Family Medicine (Licence: KY 47172) | |
| 208M00000X Hospitalist (Licence: KY 47172) | |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2022-09-22 |