| NPI | 1134175987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 39352) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 42882) |
| 207R00000X Internal Medicine (Licence: KY 42882) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2021-04-28 |