| NPI | 1700231552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101271001) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.135033) |
| 208M00000X Hospitalist (Licence: OH 35.135033) | |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2021-07-02 |