| NPI | 1154524148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 43412) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: KY 43412) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2022-05-18 |