| NPI | 1083971311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35099224) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 112222) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2022-12-15 |