| NPI | 1700499555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD215102) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD215102) |
| 207R00000X Internal Medicine (Licence: OH 57.249957) | |
| Enumeration Date | 2020-08-30 |
| Last Update Date | 2023-11-08 |