| NPI | 1780092973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 50226) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 50226) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2017-07-10 |