| NPI | 1982833133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.139316) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NH 15612) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.246458) | |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2021-09-08 |