| NPI | 1104498724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY TP432) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.150237) |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2025-06-04 |