| NPI | 1720473564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS14528) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 0116) |
| 207R00000X Internal Medicine (Licence: WV 0117) | |
| 208M00000X Hospitalist (Licence: WV 0116) | |
| 208M00000X Hospitalist (Licence: FL OS14528) | |
| 208M00000X Hospitalist (Licence: WV 0117) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2021-06-30 |