| NPI | 1801059399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 42746) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 42746) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: KY 42746) | |
| Enumeration Date | 2008-07-06 |
| Last Update Date | 2024-06-27 |