| NPI | 1497173850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35130059) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301113451) |
| 207R00000X Internal Medicine (Licence: IN 01087512A) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2025-01-10 |