| NPI | 1093150708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME117458) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL me117458) |
| 207P00000X Emergency Medicine (Licence: KY 51311) | |
| 208M00000X Hospitalist (Licence: FL me117458) | |
| 208M00000X Hospitalist (Licence: KY 51311) | |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2019-01-14 |