| NPI | 1235545773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 65371) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 65371) |
| 207P00000X Emergency Medicine (Licence: KY 50107) | |
| 207R00000X Internal Medicine (Licence: KY 50107) | |
| Enumeration Date | 2014-07-04 |
| Last Update Date | 2022-07-28 |