| NPI | 1205862067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 51399) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301073747) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2022-10-11 |