| NPI | 1073074555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY TP862) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY TP862) |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2022-06-10 |