| NPI | 1700919776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 25530) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.053911) |
| 208M00000X Hospitalist (Licence: KY 25530) | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2017-04-07 |