| NPI | 1356722409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 51615) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY 51615) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2018-09-13 |