| NPI | 1205368081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.141345) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 72473) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2025-08-21 |