| NPI | 1295141810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 269584) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.14654) |
| 207R00000X Internal Medicine (Licence: IN 01088932A) | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2025-01-21 |