| NPI | 1902841539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 24838) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101235521) |
| 207Q00000X Family Medicine (Licence: VA 0101235521) | |
| 208M00000X Hospitalist (Licence: VA 0101235521) | |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2023-07-25 |