| NPI | 1972723104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN MD0000044395) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME MD27367) |
| 207R00000X Internal Medicine (Licence: TN MD0000044395) | |
| 208M00000X Hospitalist (Licence: TN MD0000044395) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2023-10-05 |