| NPI | 1629377148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 03861) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 03861) |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2023-05-16 |