| NPI | 1376786772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 39053) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TN 49006) |
| 207R00000X Internal Medicine (Licence: TN 49006) | |
| 208M00000X Hospitalist (Licence: TN 49006) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2021-06-14 |