| NPI | 1710475553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2021-00332) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.245813) |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2021-08-10 |