| NPI | 1720407018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 51794) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 51794) |
| 207RS0012X Internal Medicine Sleep Medicine (Licence: KY 51794) | |
| 208M00000X Hospitalist (Licence: KY 51794) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2021-09-01 |