| NPI | 1215210281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 263007) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01070250A) |
| 207R00000X Internal Medicine (Licence: NY 263007) | |
| 207R00000X Internal Medicine (Licence: MI 4301099793) | |
| 207R00000X Internal Medicine (Licence: OH 35.099433) | |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2016-09-28 |