| NPI | 1104169697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.128066) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.128066) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2023-05-05 |