| NPI | 1972786911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A116485) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A116485) |
| 207R00000X Internal Medicine (Licence: OH 57014157) | |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2026-08-24 |