| NPI | 1316978034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 40654) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY TP576) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2014-03-11 |