| NPI | 1245204619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 29280) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY 29280) |
| 207R00000X Internal Medicine (Licence: KY 29280) | |
| 207P00000X Emergency Medicine (Licence: IN 01044209A) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2008-08-14 |