| NPI | 1992782031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 1446) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 03315) |
| 208M00000X Hospitalist (Licence: WV 1446) | |
| 207P00000X Emergency Medicine (Licence: WV 1446) | |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2018-08-06 |