NPI | 1609133834 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 26416) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: WV 26416) |
Enumeration Date | 2012-04-12 |
Last Update Date | 2022-09-15 |