| NPI | 1003201815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.133319) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125066234) |
| 207R00000X Internal Medicine (Licence: OH 35.133319) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2019-02-22 |