NPI | 1417222357 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208M00000X Hospitalist (Licence: WV 28033) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME124416) |
208M00000X Hospitalist (Licence: PA MD446064) | |
Enumeration Date | 2012-03-11 |
Last Update Date | 2021-04-13 |