| NPI | 1679764054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2010-01202) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2010-01202) |
| 207Q00000X Family Medicine (Licence: KY R1569) | |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2023-06-14 |