| NPI | 1861562928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 45847) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 22478) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2021-08-24 |