| NPI | 1770696254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS R8673) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO R8673) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-09-11 |