| NPI | 1104116326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35146886) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101258439) |
| 207R00000X Internal Medicine (Licence: OH 35146886) | |
| 207R00000X Internal Medicine (Licence: TN 64087) | |
| 208000000X Pediatrics (Licence: VA 0101258439) | |
| 208000000X Pediatrics (Licence: OH 35146886) | |
| 208000000X Pediatrics (Licence: TN 64087) | |
| 208M00000X Hospitalist (Licence: VA 0101258439) | |
| 208M00000X Hospitalist (Licence: TN 64087) | |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2023-05-19 |