| NPI | 1376032268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD477545) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.246533) |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2022-10-20 |