| NPI | 1770748667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 44246) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IN 01073931A) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2019-01-17 |