| NPI | 1598490476 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 94548)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.253385)  | 
| Enumeration Date | 2022-07-23 | 
| Last Update Date | 2025-07-09 |