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 |