| NPI | 1639699242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 54127) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY 54127) |
| Enumeration Date | 2017-06-24 |
| Last Update Date | 2025-06-09 |