| NPI | 1194728329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 34008222) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 50856-21) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2015-07-23 |