| NPI | 1831571009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: OH 34.014054) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10053241) |
| 208M00000X Hospitalist (Licence: OH 34.014054) | |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2023-02-27 |