| NPI | 1508444217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY TP407) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.150612) |
| 208M00000X Hospitalist (Licence: KY TP407) | |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2025-07-31 |