| NPI | 1619330396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.143057) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 301623) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2021-08-05 |