| NPI | 1962411439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WV 2073) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 34010323) |
| 207R00000X Internal Medicine (Licence: SD 10109) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2025-12-18 |