| NPI | 1629634753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.146452) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.146452) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2023-05-05 |