| NPI | 1053722371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 54762) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01081230A) |
| 207R00000X Internal Medicine (Licence: OH 35.127174) | |
| 207R00000X Internal Medicine (Licence: KY 54762) | |
| Enumeration Date | 2014-05-09 |
| Last Update Date | 2023-09-21 |