| NPI | 1891700662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 37983) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35072662) |
| 208M00000X Hospitalist (Licence: KY 37983) | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2017-04-07 |