| NPI | 1205149408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.121260) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT196487) |
| 207R00000X Internal Medicine (Licence: OH 35.121260) | |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2014-01-27 |