| NPI | 1558037804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 33554) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WV 33554) |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2024-09-26 |