| NPI | 1487216990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 57238) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125074708) |
| 207R00000X Internal Medicine (Licence: KY TP966) | |
| 207R00000X Internal Medicine (Licence: KY 57238) | |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2025-08-04 |