NPI | 1366162703 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2025012043) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2025012043) |
207R00000X Internal Medicine (Licence: OH 57.253048) | |
Enumeration Date | 2022-08-29 |
Last Update Date | 2025-04-11 |