| NPI | 1699745646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 35368) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 35368) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: KY 35368) | |
| 208M00000X Hospitalist (Licence: KY 35368) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2015-11-11 |