NPI | 1407295959 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 29253) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 49190) |
208M00000X Hospitalist (Licence: KY 49190) | |
Enumeration Date | 2013-06-18 |
Last Update Date | 2019-10-17 |