| NPI | 1548502677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 29003) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 29003) |
| 207R00000X Internal Medicine (Licence: TN 52196) | |
| 207R00000X Internal Medicine (Licence: VA 0101258141) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2016-00998) | |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2022-04-20 |