| NPI | 1063578706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35087276) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 50687) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2008-06-23 |