| NPI | 1679574875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 43283) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 200201246) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2022-01-21 |