| NPI | 1801864053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 38777) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 38777) |
| 208M00000X Hospitalist (Licence: KY 38777) | |
| Enumeration Date | 2006-03-12 |
| Last Update Date | 2019-09-11 |