| NPI | 1700564457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.154718) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.254438) |
| Enumeration Date | 2023-07-11 |
| Last Update Date | 2026-01-14 |