| NPI | 1053561498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0011803) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 201101683) |
| 208M00000X Hospitalist (Licence: VA 0101252620) | |
| 208M00000X Hospitalist (Licence: WV 24218) | |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2016-08-24 |