| NPI | 1255497822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 39848) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY 39848) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2015-02-02 |