| NPI | 1396240248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.143392) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 30944) |
| 208M00000X Hospitalist (Licence: WV 30944) | |
| 208M00000X Hospitalist (Licence: OH 35.143392) | |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2025-08-20 |