| NPI | 1699152686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 57755) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY 50595) |
| 207Q00000X Family Medicine (Licence: KY 50595) | |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2019-09-26 |