| NPI | 1083097356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 62158) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301107282) |
| 207R00000X Internal Medicine (Licence: OH 35.133669) | |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2021-09-02 |