| NPI | 1063827525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: KY 04256) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 04256) |
| 207Q00000X Family Medicine (Licence: WV ED0455A) | |
| 208M00000X Hospitalist (Licence: IN 02005779A) | |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2022-06-10 |