| NPI | 1558704593 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0001X (Licence: GA 101488) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35127893) | 
| 208M00000X Hospitalist (Licence: OH 35.127893) | |
| Enumeration Date | 2013-04-09 | 
| Last Update Date | 2025-02-03 |