| NPI | 1487936563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.129608) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 129608) |
| 208M00000X Hospitalist (Licence: WV 26010) | |
| 208M00000X Hospitalist (Licence: WA MD60888864) | |
| 208M00000X Hospitalist (Licence: OH 35.129608) | |
| 207Q00000X Family Medicine (Licence: WV 26010) | |
| 207Q00000X Family Medicine (Licence: WA MD60888864) | |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2024-03-11 |