| NPI | 1508807876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 0101050730) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 9400256) |
| 208M00000X Hospitalist (Licence: TN 0101050730) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2018-06-11 |