| NPI | 1760059042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.152163) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.254577) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2026-05-07 |