| NPI | 1457779407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01081311A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV WV-SE-1766) |
| 208M00000X Hospitalist (Licence: WV WV-SE-1766) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-06 |
| Last Update Date | 2022-10-12 |