| NPI | 1689961278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.131887) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY TP694) |
| 208M00000X Hospitalist (Licence: IN 01091693A) | |
| 207R00000X Internal Medicine (Licence: MI 4301098858) | |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2024-01-15 |