| NPI | 1124514039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.142809) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 30937) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: OH 35.142809) | |
| 208M00000X Hospitalist (Licence: OH 35.142809) | |
| 208M00000X Hospitalist (Licence: WV 30937) | |
| Enumeration Date | 2018-07-03 |
| Last Update Date | 2024-01-31 |