| NPI | 1629125679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 40714) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 40714) |
| 208M00000X Hospitalist (Licence: IN 01083255A) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-03-10 |