| NPI | 1720038557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 1061) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 1239) |
| 207Q00000X Family Medicine (Licence: OH 34005153) | |
| 208M00000X Hospitalist (Licence: OH 34.005153) | |
| 208M00000X Hospitalist (Licence: TN 1061) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2019-03-17 |