| NPI | 1902397722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 322478) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.142872) |
| 207R00000X Internal Medicine (Licence: PA MT215127) | |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2023-08-09 |