| NPI | 1740939867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34.017723) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WV 4662) |
| 208M00000X Hospitalist (Licence: OH 34.017723) | |
| 207R00000X Internal Medicine (Licence: WV 4662) | |
| Enumeration Date | 2022-03-23 |
| Last Update Date | 2025-10-27 |