| NPI | 1629509013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WV 29900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 29900) |
| 208M00000X Hospitalist (Licence: OH 35.138869) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2021-02-19 |