| NPI | 1912981150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 38158) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 38158) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2013-12-18 |