| NPI | 1801424130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 5364) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34C.000745) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2026-07-16 |