| NPI | 1376869461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: KY TP520) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TN 48784) |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2020-12-10 |