| NPI | 1215516273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 328092) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 328092) |
| 207R00000X Internal Medicine (Licence: OH 34.017231) | |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2025-08-11 |