| NPI | 1275236242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD495437) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.254802) |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2026-08-20 |