| NPI | 1518041029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 51156) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY TP300) |
| 207R00000X Internal Medicine (Licence: OR 190080) | |
| 207R00000X Internal Medicine (Licence: NC 201702633) | |
| 207R00000X Internal Medicine (Licence: CA 55182) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2021-08-27 |