| NPI | 1063408862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 44725-21) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34-008608) |
| 208M00000X Hospitalist (Licence: WI 44725-21) | |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2012-07-02 |