| NPI | 1679076491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 57422) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01089321A) |
| 207Q00000X Family Medicine (Licence: KY 57422) | |
| 208M00000X Hospitalist (Licence: IN 01089321A) | |
| Enumeration Date | 2018-03-18 |
| Last Update Date | 2023-12-19 |