| NPI | 1912260662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 03758) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01065277A) |
| 207R00000X Internal Medicine (Licence: VA 0116024840) | |
| 207R00000X Internal Medicine (Licence: KY TP949) | |
| 208M00000X Hospitalist (Licence: KY 03758) | |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2019-11-25 |