| NPI | 1861980179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 34.016650) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO6232) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2024-01-25 |