| NPI | 1942594924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2015-02195) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101256996) |
| 207R00000X Internal Medicine (Licence: NC 2015-02195) | |
| 207R00000X Internal Medicine (Licence: WV 25957) | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2022-09-09 |