| NPI | 1790489532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.156009) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.156009) |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2026-05-01 |