| NPI | 1972034213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 60572) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY R4428) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2022-04-01 |