| NPI | 1124044771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2011-01467) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 40269) |
| 207R00000X Internal Medicine (Licence: NC 2011-01467) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2025-07-16 |