| NPI | 1275854143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY TP792) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: KY TP792) | |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2011-07-19 |