| NPI | 1396165163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.145236) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01079462A) |
| 207R00000X Internal Medicine (Licence: WV 29593) | |
| 208M00000X Hospitalist (Licence: OH 35.145236) | |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2022-06-20 |