| NPI | 1750336178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 34005739) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 3267) |
| 207R00000X Internal Medicine (Licence: OH 34005739S) | |
| 207R00000X Internal Medicine (Licence: GU DO0082) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2018-05-24 |