| NPI | 1427472182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 51500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2015-0699) |
| 207R00000X Internal Medicine (Licence: PA MD461755) | |
| 207P00000X Emergency Medicine (Licence: PA MD461755) | |
| 207P00000X Emergency Medicine (Licence: NY 281938) | |
| 207P00000X Emergency Medicine (Licence: WV 26834) | |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2023-11-10 |