| NPI | 1639372360 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34.015407) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS014149) | 
| 207R00000X Internal Medicine (Licence: PA OT011861) | |
| 208M00000X Hospitalist (Licence: PA OS014149) | |
| Enumeration Date | 2007-06-08 | 
| Last Update Date | 2023-01-16 |