| NPI | 1407295959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 29253) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY 49190) |
| 207R00000X Internal Medicine (Licence: KY 49190) | |
| 207R00000X Internal Medicine (Licence: WV 29253) | |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2024-09-26 |