| NPI | 1164840187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.130652) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 65344) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2018-01-26 |