| NPI | 1124759741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.155184) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.155184) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IL 125079466) | |
| 207R00000X Internal Medicine (Licence: FL 36859) | |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2026-05-14 |