| NPI | 1699352575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.148881) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.148881) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208D00000X General Practice (Licence: OH 35.148881) | |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2024-07-15 |