| NPI | 1700174232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.138642) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 61639) |
| 207R00000X Internal Medicine (Licence: OH 35.138642) | |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2023-05-05 |