| NPI | 1912272196 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 47770)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 282895)  | 
| 208M00000X Hospitalist (Licence: KY 47770)  | |
| Enumeration Date | 2012-03-20 | 
| Last Update Date | 2023-08-06 |