| NPI | 1114231297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 120693) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036133490) |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2017-03-14 |