| NPI | 1386689479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 40143) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 40143) |
| 208M00000X Hospitalist (Licence: CA CA179354) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2026-05-06 |