NPI | 1215375423 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS14771) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV ED0468A) |
208D00000X General Practice (Licence: FL UO3663) | |
208M00000X Hospitalist (Licence: FL OS14771) | |
Enumeration Date | 2013-06-10 |
Last Update Date | 2025-01-22 |