| NPI | 1942615752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY TP608) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY TP608) |
| 208000000X Pediatrics (Licence: KY TP608) | |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2018-06-14 |