| NPI | 1043215791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 19812) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WV 19812) |
| 208M00000X Hospitalist (Licence: WV 19812) | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: WV 19812) | |
| Enumeration Date | 2005-06-19 |
| Last Update Date | 2009-09-08 |