| NPI | 1629240643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35139963) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 43671) |
| 207Q00000X Family Medicine (Licence: NC 140962) | |
| 207Q00000X Family Medicine (Licence: KY 43671) | |
| 208M00000X Hospitalist (Licence: KY 43671) | |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2020-07-08 |