| NPI | 1902834211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WV 28544) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 28544) |
| 208M00000X Hospitalist (Licence: PA MD422001) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2025-06-05 |