| NPI | 1356731897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101262026) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.131839) |
| 207P00000X Emergency Medicine (Licence: OH 35.131839) | |
| 208M00000X Hospitalist (Licence: VA 0101262026) | |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2020-06-19 |