| NPI | 1205822004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 50492) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME76597) |
| 208M00000X Hospitalist (Licence: FL ME76597) | |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2025-11-21 |