| NPI | 1023301371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 25800) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WV 25800) |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2022-08-24 |