| NPI | 1730683038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.154207) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CT 67555) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2025-09-12 |