| NPI | 1104075316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME123067) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WV WV-SE-1731) |
| 208M00000X Hospitalist (Licence: FL ME123067) | |
| 207R00000X Internal Medicine (Licence: WV WV-SE-1731) | |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2021-05-04 |