| NPI | 1801905898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME88314) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV WV-SE-1713) |
| 208M00000X Hospitalist (Licence: FL ME88314) | |
| 208M00000X Hospitalist (Licence: WV WV-SE-1713) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2021-05-04 |