| NPI | 1609362474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.141447) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2018015696) |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2021-10-06 |