| NPI | 1710111455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WV 2243) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.011846) |
| Enumeration Date | 2009-05-10 |
| Last Update Date | 2026-01-15 |