| NPI | 1114422599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 05035) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 05035) |
| 208M00000X Hospitalist (Licence: KY 05035) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2021-08-31 |