| NPI | 1831693076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 04983) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AR E-14410) |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2021-10-07 |