| NPI | 1003212630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 51005) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY r3971) |
| 208M00000X Hospitalist (Licence: KY 51005) | |
| 208M00000X Hospitalist (Licence: IN 01086775A) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2021-11-17 |