| NPI | 1134223738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 20462) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WV 20462) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2022-08-24 |