| NPI | 1679828644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 51406) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 51406) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2018-06-26 |