| NPI | 1245580331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 02006538A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND 12874) |
| 207R00000X Internal Medicine (Licence: OH 34012344) | |
| 208M00000X Hospitalist (Licence: ND 12874) | |
| Enumeration Date | 2012-09-15 |
| Last Update Date | 2021-09-30 |