| NPI | 1073747424 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IA MD-41010) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.012559) | 
| 207R00000X Internal Medicine (Licence: IA MD-41010) | |
| Enumeration Date | 2009-05-13 | 
| Last Update Date | 2017-11-09 |