| NPI | 1548605421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 49844) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 49844) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 49844) | |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2021-01-29 |