| NPI | 1255503033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME114383) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV WV-SE-1708) |
| 208M00000X Hospitalist (Licence: WV WV-SE-1708) | |
| 208M00000X Hospitalist (Licence: FL ME114383) | |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2021-05-04 |