| NPI | 1942656087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NH 21742) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301109482) |
| 207R00000X Internal Medicine (Licence: OH 35135673) | |
| 208M00000X Hospitalist (Licence: OH 35135673) | |
| Enumeration Date | 2016-05-08 |
| Last Update Date | 2021-08-16 |