| NPI | 1629263454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 47383) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY R3074) |
| 207R00000X Internal Medicine (Licence: KY 47383) | |
| 208M00000X Hospitalist (Licence: KY 47383) | |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2021-12-16 |