| NPI | 1962405019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME74685) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.096390) |
| 207P00000X Emergency Medicine (Licence: PA MD441349) | |
| 207P00000X Emergency Medicine (Licence: WI 36422) | |
| 207R00000X Internal Medicine (Licence: TN 53240) | |
| 208M00000X Hospitalist (Licence: TN 53240) | |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2025-02-06 |