| NPI | 1598145534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 02005585A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 3509) |
| 207R00000X Internal Medicine (Licence: PA OS018476) | |
| 207R00000X Internal Medicine (Licence: OH 34013972) | |
| 208M00000X Hospitalist (Licence: WV 3509) | |
| 208M00000X Hospitalist (Licence: OH 34013972) | |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2021-09-09 |