| NPI | 1174709968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME104484) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME104484) |
| 208M00000X Hospitalist (Licence: WV WV-SE-1729) | |
| 207R00000X Internal Medicine (Licence: WV WV-SE-1729) | |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2023-07-06 |