| NPI | 1790191831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-40195) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME131031) |
| 207R00000X Internal Medicine (Licence: IN 01080389A) | |
| 208M00000X Hospitalist (Licence: WV 27656) | |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2022-01-14 |