| NPI | 1790041614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101257921) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 49921) |
| 207P00000X Emergency Medicine (Licence: NC 2014-02000) | |
| 208M00000X Hospitalist (Licence: KY 49921) | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2019-08-24 |