| NPI | 1205418589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34.017777) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 34.017777) |
| 208000000X Pediatrics (Licence: WV 4621) | |
| 207R00000X Internal Medicine (Licence: WV 4621) | |
| 208M00000X Hospitalist (Licence: WV 4621) | |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2025-10-27 |