| NPI | 1760800304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD465057) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD465057) |
| 207R00000X Internal Medicine (Licence: OH 35.131307) | |
| 208M00000X Hospitalist (Licence: OH 35.131307) | |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2021-07-16 |