| NPI | 1508144064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35121224) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.121224) |
| 207R00000X Internal Medicine (Licence: WV 29311) | |
| 208M00000X Hospitalist (Licence: WV 29311) | |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2024-02-19 |