| NPI | 1649665134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34.013374) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CO DR.0074751) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2025-04-29 |