| NPI | 1841710597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 04905) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101023524) |
| 207R00000X Internal Medicine (Licence: KY 04905) | |
| 208M00000X Hospitalist (Licence: KY 04905) | |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2022-07-21 |