| NPI | 1124018072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 36850) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 36850) |
| 208M00000X Hospitalist (Licence: OH 35.076987) | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2025-06-26 |