| NPI | 1568690162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 44495) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: LA MD.206810) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2020-07-14 |