| NPI | 1053524868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.090049) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.090049) |
| 207R00000X Internal Medicine (Licence: NE 4974) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2021-09-13 |