| NPI | 1871532366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 40772) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY 40772) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME0084183) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 40772) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2014-07-08 |