| NPI | 1396165866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 04143) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 04143) |
| 207Q00000X Family Medicine (Licence: KY 04143) | |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2020-12-14 |