| NPI | 1093452617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 34927) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WV 34927) |
| Enumeration Date | 2022-05-16 |
| Last Update Date | 2025-07-28 |