| NPI | 1841368636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0092028) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME0092028) |
| 207R00000X Internal Medicine (Licence: WV WV-SE-1715) | |
| 208M00000X Hospitalist (Licence: WV WV-SE-1715) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2021-05-19 |