| NPI | 1235573478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101258875) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101258875) |
| 208M00000X Hospitalist (Licence: VA 0101258875) | |
| 207Q00000X Family Medicine (Licence: KY 48400) | |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2022-10-27 |