| NPI | 1922760073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 55666) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY 55666) |
| Enumeration Date | 2021-10-06 |
| Last Update Date | 2023-11-18 |