| NPI | 1225345341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 03502) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 58.003281) |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2022-03-15 |