| NPI | 1508251315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME136058) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV WV-SE-1793) |
| 208M00000X Hospitalist (Licence: FL ME136058) | |
| 208M00000X Hospitalist (Licence: WV WV-SE-1793) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2021-06-16 |