| NPI | 1053730705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35138902) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CO DR.0058007) |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2020-06-23 |