| NPI | 1811516602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 05479) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 05479) |
| 207R00000X Internal Medicine (Licence: IN 02007328A) | |
| 208M00000X Hospitalist (Licence: IN 02007328A) | |
| 208M00000X Hospitalist (Licence: OH 34.015792) | |
| Enumeration Date | 2020-04-11 |
| Last Update Date | 2023-12-19 |