| NPI | 1518198761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WV 25251) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WV 25251) |
| 207R00000X Internal Medicine (Licence: WV 25251) | |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2016-08-18 |